NPIMap

Organization Active NPI

Prisma Health University Medical Group

  • Pediatric Endocrinology Physician
  • Greenville, SC
National Provider Identifier
1932436631
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Practice address
200 Patewood Dr
Suite A200
Greenville, SC 29615-3593
Phone
(864) 454-5100
NPI assigned
Nov 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristi Ann Lawrence
Title
Director Provider Enrollment
Phone
(864) 385-4790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0205X Primary

Addresses

Primary practice location

200 Patewood Dr
Suite A200
Greenville, SC 29615-3593

Mailing address

7 Independence PT Ste 140
Greenville, SC 29615-4550
Phone (864) 385-4790

Other identifiers 2

IdentifierTypeStateIssuer
20029654OtherSCSELECT HEALTH ID NUMBER
DPE074MedicaidSC

Other names 1

  • University Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
GHS Partners in Health34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

200 Patewood Dr
Ste A200
Greenville, SC 29615
Phone (864) 454-5115

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1932436631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 140",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154550",
            "telephone_number": "864-385-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "address_2": "SUITE A200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-454-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMA HEALTH UNIVERSITY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "864-385-4790"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH ID NUMBER",
            "identifier": "20029654",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DPE074",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.